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• W3212188136 abstract "<h3>Introduction</h3> Mortality following acute decompensation (AD) of alcohol-related chronic liver disease remains high despite significant advances in in-patient therapeutics and supportive care. Ongoing specialist support is recommended for all survivors and yet many patients are lost to follow up over time, potentially impacting outcomes. We retrospectively analysed a cohort of patients who survived an AD event and were offered specialist clinic follow up in our centre. <h3>Methods</h3> Electronic records were reviewed for all patients surviving an admission for AD and offered rapid local follow up (within 4 weeks), from January 2016 to December 2017. Demographic data, clinic attendances and clinical course (Child-Pugh/MELD scores at 1, 3, 6, and 12 months) were recorded, as well as 1-year mortality and abstinence rates. <h3>Results</h3> 129 unique patients were included (32% female; 68% male), with median age 53 (range 29-83). Mortality was 24% (n=31) at 1 year, in keeping with published cohorts. Of these, 55% (n=17) were directly attributable to liver disease. At 3 years mortality reached 51% (n=66), with approximately half (48%; n=32) due to a liver cause. 91 AD survivors (71%) attended their initial appointment (non-attendance rate 29%). 1 year mortality was significantly lower in this group compared to non-attenders [18 (20%) v 14 (38%), p=0.03]. This was reflected in a downward trend in mean MELD scores for attenders at 1, 3, 6 and 12 months (15, 15, 14 and 12 respectively), whereas non-attenders showed static or worsening disease (14, 15, 17, 14). Similarly, Child-Pugh (CP) scores showed significantly greater numbers of attenders recompensated to CP-A by 12 months [29 (32%) v 5 (16%), p=0.033]. Nearly half (47%; n=60) of all patients were still drinking alcohol at 1 year. However, those who attended the first appointment were significantly more likely to be abstinent at 1 year than those who did not [42 (46%) v 6 (16%), p=0.002], which is considered the most likely reason for better 1-year survival in this group. <h3>Conclusions</h3> Our results show that poor initial engagement with follow up is very common, and is associated with lower rates of abstinence, recompensation, and survival at 1 year. There are likely to be many reasons patients cannot or do not attend. Exploring these factors - and identifying ways to promote engagement - should be considered a high priority to improve longer-term outcomes." @default.
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• W3212188136 date "2021-11-01" @default.
• W3212188136 modified "2023-09-25" @default.
• W3212188136 title "PWE-4 Clinic non-attendance in alcohol-related liver disease is very common, and linked to poorer 1-year outcomes" @default.
• W3212188136 doi "https://doi.org/10.1136/gutjnl-2021-bsg.194" @default.
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